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Permit
CITY OF TIGARD PERMIT PERMIT #: ELC1999 -00624 1J I DEVELOPMENT SERVICES (" ..DATE ISSUED: 10/21/99 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 J t /PARCEL: 2S110CD -00102 SITE ADDRESS: 15340 SW ROYALTY PKWY {f 't L SUBDIVISION: KING CITY NO. 2 ZONING: BLOCK: LOT : 002 JURISDICTION: KIN Project Description: Installation of 3 sign lightings. Job No. 633 -8436 RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: 3 LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL: MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: JOE MCCANN WILLAMETTE ELECTRIC INC 15405 SW 116TH AVE PO BOX 230547 KING CITY, OR 97224 TIGARD, OR 97281 Phone: Phone: 624 -3631 Reg #: LIC 000750 SUP 1965S ELE 34 -283C FEES Required Inspections Type By Date Amount Receipt Elect'I Service PRMT DEB 10/21/99 $128.25 99- 319233 Elect'l Final 5PCT DEB 10/21/99 $10.26 99- 319233 • Total $138.51 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Spedalty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not starjed within 180 days of issuance, or if work is . suspended for more than 180 days. ATTENTION: Oregon law requires you to follow r adopted by - Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obt • copies of these rule or direct questions to OUNC at (503) 246 -1987. / PERMITTEE'S SIGNATURE . I SUED BY: OWNER INSTALLATIO The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: . DATE: LICENSE NO: / %�SS Call 639 -4175 by 7:00pm for an inspection the next business day CITY OF TIGARD Electrical Permit Application Plan C ck# 13125 SW HALL BLVD. Recd y ' TIGARD OR 97223 Date Recd /0 ' 1 Date to P.E. Phone (503) 639 -4171, x304 Date to DST ----- ��,,//,,,��, Inspection (503) 639 -4175 Print of Type Permit# fte /9�t9- e� -q Fax (503) 598 -1960 2 0`eml _ 7 - 7 Incomplete or illegible will not be accepted Called 1. Job Address: 4. Complete Fee Schedule Below: • Name of Development Number of Inspections per permit allowed Name (or name of business) _ - i : - - A .J Service included: Items Cost . Sum 4 Address I S3 y0 51.1. km "7-4/--v - :, ' 4a. Residential - per unit City /State /Zip i'/1/ �i (� g7 7- 1000 sq. ft. or less $ 117.75 4 g ' �, Each additional 500 sq. ft. or / portion thereof $ 26.25 1 Commercial W Residential ❑ Limited Energy $ 60.00 Each Manufd Home or Modular 2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2 (Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders information for COT data base) Installation, alteration, or relocation Electrical Contr or , Lai zWi� 1- • _/_:-_-1[ _ .1 _ 200 amps or less $ 64.25 2 Address 1 , __ iao 230 5 201 amps to 400 amps $ 85.50 2 l! 401 amps to 600 amps $ 128.50 2 City 1 a State © Zlp 601 amps to 1000 amps $ 192.50 2 Phone No. '" - �3 /Doz(/ 3 , ( Over 1000 amps or volts $ 363.75 2 Job No. (O 3 3 g y',3 0 Reconnect only $ 53.50 2 Elec. Cont. Lice. No. C- Exp.Date /t a • 4c. Temporary Services or Feeders OR State CCB Reg. No. 6 Exp.Date • !o i Installation, alteration, or relocation COT Business Tax or Metro No. It Exp.Date _ %/1Ae. 200 amps or less $ 53.50 2 201 amps to 400 amps $ 80.25 2 Signature of Supr. Elec'n C 401 amps to 600 amps $ 107.00 2 w Over 600 amps to 1000 volts, License No. / GS- 5 Exp.Date r •� ` see "b" above. ' Phone No. .673 - -6 3( 4d. Branch Circuits New, alteration or extension per panel a) The fee for branch circuits 2b. For owner installations: with purchase of service or feeder fee. Print Owner's Name Each branch circuit $ 5.35 2 Address b) The fee for branch circuits without purchase of service City State Zip or feeder fee. Phone No. First branch circuit $ 37.50 Each additional branch circuit $ 5.35 The installation is being made on property I own which is not 4e. Miscellaneous intended for sale, lease or rent. (Service or feeder not included) Each pump or irrigation circle $ 42.75 Owner's Signature Each sign or outline lighting 3 $ 42.75 1'ZS �/-' Signal circuit(s) or a limited energy 3. Plan Review section (if required):* panel, alteration or extension $ 60.00 Minor Labels bels (10) $ 107.00 Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over 4 or more residential units in one structure the allowable in any of the above Service and feeder 225 amps or more Per inspection $ 50.00 Per hour $ 50.00 System over 600 volts nominal In Plant $ 59.00 Classified area or structure containing special occupancy as described in N.E.C. Chapter 5 5. Fees: 2 2s 5a. Enter total of above s $ * Submit 2 sets of plans with application where any of the above apply. r /o Surcharge X total fees) $ 1 0 ' Not required for temporary construction services. Subtotal $ 1.3e gi- 5b. Enter 25% of line 5a for NOTICE Plan Review if required (Sec. 3) $ PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account # V AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ I3g I: \dsts \forms \electric.doc ., Ait KING CITY 15300 S.W. 116th Avenue, King City, Oregon 97224-2693 Phone: (503) 639 -4082 • FAX (503) 639 -3771 Notice To Contractors Working In King City Due to an intergovernmental agreement with the City of Tigard, many building related permits for projects in King City are issued and inspected by the City of Tigard. If your permit application DOES NOT REQUIRE PLAN REVIEW, simply complete the appropriate application legibly and submit it to the King City staff The King City staff will collect all fees and fax the application to the City of Tigard. City of Tigard staff will then create the permit, issue the permit, and perform inspections. Please indicate on the permit application whether you would like the Tigard staff to call you when the permit is ready for issuance or whether you prefer it to be mailed without any notification. Any incomplete or illegible application will be returned to King City staff for correction and no processing will occur until a complete, legible application is received. If your permit application DOES REQUIRE PLAN REVIEW, this form must be signed by a King City staff person. King City staff will simply sign this form indicating land use approval. Take this signed form to the City of Tigard Development Services Counter located at 13125 SW Hall Blvd, Tigard, to submit applications and plans. Development Services Technicians are available at 639 -4171 Ext. 304 should you have any questions concerning submittal requirements. All permit fees will be assessed and collected at the City of Tigard. The City of King City hereby authorizes applicant to pursue permits at the City of Tigard Building Department for the following project: Wes-1- oa S - 1 located at: /53f 360 aval_i L___ i .� / JA 1 King City f epresentative I:'DSTSUKC[NST.DOC 02/17/2000 Activities for Case #: ELC1999 -00624 2:49:35 PM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes ELCC001 Application received , 10/21/1999 DEB DONE No Hold DEB 10/21/1999 ELCC003 Permit created 10/21/1999 DEB DONE No Hold DEB 10/21/1999 ELCC730 Elect'l Service 10/21/1999 10/21/1999 No Hold DEB 10/21/1999 ELCC799 Elect'I Final 10/21/1999 10/21/1999 10/22/1999 BP PASS No Hold JMT 11/09/1999 ELCC500 (F)Issue permit 10/21/1999 DEB DONE No Hold DEB 10/21/1999 ELCA800 Case finaled 11/09/1999 JMT DONE No Hold JMT 11/09/1999 . Page 1 of 1 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 - 4171 BUP Date Requested lo(a 1 .19 AM PM BLD /53 `? Location /' 0 -L J PO f OJ-( Suite MEC Contact Person f b Ph 494)-`/' 34 PLM Contractor Ph SWR • BUILDING Tenant/Owner ELC M q? ea V Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes:F4 3 � C1 Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing /.7-L/T_ -c _JD." Firewall yy Fire Sprinkler r Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final T FAIL ("ELECTRICAL T Service Rough In UG /Slab Low Voltage Fire Alarm Fi � AS) PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Z1i � Date /O g Inspector /1��./.r/ Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.